Begin the decline.

Begin the decline

Those trendsetters in the Northeast and on the West Coast have done it again. According to a study by Steve Wing and his colleagues at the University of North Carolina at Chapel Hill, Northeast and West Coast states were the first to show the decline in deaths from heart disease, a trend now being enjoyed by the entire country.

"Heart disease mortality rose during most of the first half of the century rather dramatically," he says. "At the national level, mortality began to drop starting about 1968."

When he and his colleagues analyzed the decline by "state economic areas" -- groups of similar counties -- they found some areas had had a head start. Looking at the statistics for heart disease in white men between 35 and 74 years old, the researchers found that metropolitan state economic areas experienced the decline before nonmetropolitan areas, and northeastern and Pacific Coast states beat out the South and midsection of the country.

"We don't have any data on the reasons for the pattern," says Wing, who presented the findings at last week's Conference on Cardiovascular Disease Epidemiology in San Francisco. Causes for the earlier decline could be any of the social, labor, economic, cultural or dietary changes that began first on the coasts, he says. But the findings didn't surprise him. "It's part of American folk culture that we expect things to spread from the coasts."